Vermont's Prisons Struggle to Accommodate an Aging Population 

An old man, hunched over and weak, scoots to the edge of his bed and struggles, slowly, into a pair of loose gray sweatpants.

“I’m going to make myself something to eat now,” he tells the superintendent making the rounds. “Beef stew.” He gestures to the container of instant noodles on a cluttered bedside table.

“They sell this in the commissary?” Mark Potanas asks, not unkindly. Then he moves on — through the 10-bed infirmary, past the offices of nurses and physician assistants.

Outside, in the sharp cold of a clear winter day, a few old-timers huddle in wheelchairs on the edge of a bleak yard, their standard-issue orange stocking caps pulled snug over their ears.

And in nearby Charlie Unit, men sit quietly at communal tables, bent over playing cards and magazines. Their adjacent single rooms are claustrophobic but offer a small, cherished measure of privacy. One white-haired man with an eye patch peeks out from behind his door, then retreats back inside.

Hospital? Nursing home? No: It’s prison — though Vermont’s Southern State Correctional Facility increasingly functions as all three.

Almost 20 percent of the prisoners at the 377-bed maximum-security prison in Springfield are ages 50 years or older; demographically speaking, that’s how the “elderly” prison population is defined.

“They’ve had a hard life,” says Potanas — himself a strapping, clean-cut 60-year-old — and it shows. The same factors that contribute to incarceration — chief among them, poverty and substance abuse — go hand in hand with poor health and limited access to care for medical, dental and mental health needs.

During a tour in late November, Potanas rattled off the details: Nine prisoners in wheelchairs. Roughly another 10 with walkers or canes. Men suffering from cancer, liver and kidney disease. A few showing early signs of Alzheimer’s disease and dementia.

“This is its own city,” said Potanas. “Aging is a problem in society, and corrections is a microcosm of society.”

The number of geriatric inmates nationwide is on the rise. In Vermont alone, the proportion of aging inmates more than doubled between 2000 and 2013, now accounting for 15.2 percent of the inmate population.

Vermont’s correctional facilities are struggling to keep up with their needs.

“We designed Charlie with this in mind,” Potanas said of the unit that became the first of its kind in Vermont when the prison was built in 2003. “However, no one expected it to go so quickly.” By July, Potanas expects that half the steel bunks in Charlie’s 24 cells will have been replaced with adjustable, hospital-style beds. Now he’s trying to figure out how to make the unit’s second floor wheelchair-accessible without breaking the budget.

Corrections officials envisioned Charlie Unit as an assisted-living facility with bars. It’s quieter than all the other areas of the prison, and the ailing inmates there have the option of having their meals and meds brought to them.

Back in November, demand for beds in that unit already exceeded supply, according to Potanas. In the corridor, he passed an old man in a wheelchair grumbling unhappily as another inmate pushed him to the exit; someone else needed his bed, so the wheelchair-bound man had been reassigned to another part of the prison.

Older inmates complain that, as they age behind bars, they struggle to obtain adequate medical care. And there are other problems: Aging inmates sometimes fall prey to the bullying or extortion of younger offenders. Cell blocks can be loud, bunks cold and uncomfortable. Walks to the chow hall or pill line get increasingly difficult to manage.

Voices From the Inside

In Vermont and the rest of the country, the elderly prisoner population is largely male. Men between the ages of 50 and 59 in the Vermont DOC outnumber women of the same age by 23 to one, according to corrections department data. Men over the age of 60 outnumber their female counterparts by 25 to one.

Springfield has the state’s largest concentration of older inmates, including Vermont’s most senior prisoner: 88-year-old John Simon, who is serving a sentence of 11 months to five years for several charges, including aggravated assault with a deadly weapon, violating an abuse-prevention order and simple assault of a law-enforcement official.

Vermont’s eldest female prisoner is 81-year-old Hope Schreiner, in for a 17-year to life sentence for killing her husband. She is imprisoned at the state’s only correctional facility for women: Chittenden Regional Correctional Facility in South Burlington. The facility housed an “average daily population” of roughly 150 incarcerated women during last fiscal year; in 2012, 12 of those women were over the age of 50.

Schreiner declined to be interviewed, but over a period of months, Seven Days talked with aging inmates at the Springfield prison. Through interviews, letters and phone calls, common themes emerged.

“Life sucks in here,” said Richard Murray, 65, in the visiting room at SSCF on a recent Sunday morning, a cane by his side. Because of the arthritis in his knees and the necessity of crossing the icy prison yard, he said he’s spent part of the winter confined to a wheelchair.

“That’s their answer to everything here: a walker, a wheelchair or a cane and some ibuprofen,” said Murray.

He’s hasn’t always had so much trouble getting around. At 53, while serving time at an out-of-state facility in Virginia, Murray played left field for the commissioner’s all-star baseball team. “They called me ‘The Beast,’” he remembered.

Murray has spent the last 19 years in prison, serving a 15- to 30-year sentence for aggravated sexual assault. He was arrested in 1995 after repeatedly molesting a young girl over the course of a decade.

“Guilty, guilty, guilty. I’m not proud of it,” said Murray. He’s since completed a targeted treatment program for sex offenders and served enough time to be eligible for release. Why is he still locked up? Murray’s one of approximately 200 inmates in the Vermont correctional system who remain behind bars solely because they can’t find housing the DOC considers “sufficient to address [the] risk” they pose to the community.

Murray doesn’t live in Charlie Unit, and, frankly, “I don’t want to go there right now,” he said. He likened it to going to a nursing home to lie down and die. But during days or weeks when his knees are particularly bad, he said he longs for the convenience the unit would bring. Instead, Murray relies on fellow inmates to push his wheelchair across the icy yard to the chow hall.

Other inmates shared their stories in snail-mail letters. One told of a 72-year-old fellow prisoner who suffered from a painful esophageal condition. “He would for hours at a time wretch and gag, which was heartbreaking to listen to,” inmate Reco Jones wrote. Jones said he asked correctional officers to call for medical assistance but was rebuffed several times. “When he was transferred to the infirmary and his cell was cleaned, his mattress was stained [with] yellow bile.”

Jones also wrote about an inmate, transferred to Southern State from another facility in late October, who waited weeks for a CPAP machine to address his sleep apnea.

Sixty-nine-year-old Burt Allen, a former New Haven selectman sentenced to eight to 15 years behind bars for lewd and lascivious conduct with an 8-year-old girl, said it took months to diagnose the bulged discs and sciatica in his lower back. At the time, he was serving time in a prison in Beattyville, Kentucky. (To ease overcrowding, Vermont contracts with the private Corrections Corporation of America to house inmates there.)

“I kept hammering. CCA sent me back to Vermont on a medical slip. Came back to Vermont Oct. 7, 2013 and here I sit,” Allen wrote in an early December letter to Seven Days. “I saw what you may consider a doctor. She claims to be, but excuse me, she is no more of a doctor than I’m a pilot. She told me here in Springfield a lot of back surgeries didn’t help and wouldn’t heal right, so now I have asked to get my medical records and a copy of my MRI so my outside attorney can look at them.”

Will Hunter, a minister who works to help former inmates find transitional housing after prison, makes no apologies for such prisoners. That they’re old and in jail suggest they’ve committed serious crimes, many of which are sex offenses.

But that doesn’t mean they aren’t entitled to human decency and adequate care, says Hunter. “This is the Department of Corrections … not the Department of You’re Never Going to Change and We’re Going to Treat You Like Dirt Because of Something You Did 30 Years Ago.”

SSCF Superintendent Mark Potanas looks out over Charlie Unit

Dr. D.O.C.

The experiences of a few individuals don’t speak for the system as a whole. That’s the opinion of Delores Burroughs-Biron, the director of health services for Vermont’s in-state prison population. Known as “Dr. Dee,” Burroughs-Biron acknowledges that inmates don’t always get medical appointments right away —  “I do think that in general everything ‘seems’ to take longer when you are waiting for it in jail,” she says — but nor do people who aren’t serving time, she points out. Prisoners with chronic diseases, such as diabetes or asthma, get in for check-ups every 90 days, and an in-house doctor and nursing staff act as the “primary care” practice for inmates.

Vermont’s prison system provides much of its routine care through a contract with a private company called Correct Care Solutions. The state’s contract with CCS came under scrutiny this fall, after a report by State Auditor Doug Hoffer criticized a “fee-for-service” agreement that provides no incentive for the contractor to contain costs.

The state ran $4.2 million over budget on the nearly $50 million contract during the first three years of its agreement with CCS. Though DOC recently extended its contract with the provider another two years, Burroughs-Biron says DOC is exploring the possibility of abandoning the private health care provider in favor of a “homegrown” model run by Vermonters. She said she thinks a small state — with a correspondingly small number of inmates to house — shouldn’t have to rely on an outside, for-profit provider for health care.

Burroughs-Biron says that the medical staff in Vermont’s correctional facilities treat their prisoner patients as they would anyone else — that is, there is no discussion about why they were convicted.

Kirk Wool, 54, confirms it — he’s 22 years into a 29- to 73-year sentence for kidnapping and aggravated sexual assault, charges he still disputes. “I have no sense whatsoever that they are indifferent to the pain or suffering of inmates,” says Wool in a phone interview.

But he nonetheless says he knows many men who are suffering — and suffering in prison, he says, is different than it would be outside those walls.

“It very quickly goes to a sense of hopelessness,” says Wool, noting it’s tempting to write off inmates as malingering or exaggerating.

Prisoners can file complaints, called grievances. Some have gone as far as to sue the DOC for what they feel is inadequate care — helped along in some cases by Wool, who drafted a fill-in-the-blanks form for prisoners looking to bring legal action.

Among the plaintiffs is 54-year-old Matthew Stevens, serving time for first-degree murder. “You wouldn’t find a gentler, kinder, softer-voiced man in your life,” says Wool, describing Stevens, who says he suffers from chronic pain, arthritis, hepatitis C and anxiety, among other disorders.

Stevens said he was sent to the CCA prison in Kentucky, where he was “generally denied medical treatment.”

“I was returned to Vermont so I can get meal trays, meds delivered,” he wrote to Seven Days by mail. “Still being forced to walk to meals and meds.”

Stevens’ lawsuit against DOC Commissioner Andy Pallito was dismissed last summer, largely, Stevens said, because he doesn’t have a doctor or expert witness to testify on his behalf. He’s appealing the decision. But the docket entry for the evidentiary hearing shows that Judge Robert Bent wasn’t unsympathetic to Stevens’ situation.

“One of the hard parts is you want somebody to stop it from hurting; harder in jail,” a court clerk wrote in the file, reporting the judge’s remarks. “Can’t change docs, go to the store, try remedy. You’re stuck … Things you’re talking about are very important. Recognize people in your shoes are in the system. Baby boomers not getting younger … I think it takes a lot of courage to put your case to the judge, and I’m glad you did. I applaud it, but I am going to deny your petition.”

Southern State Correctional Facility

Why No Takers?

Ask experts why prisons are filling up with gray-haired men and women, and almost everyone circles back to one reason: long sentences.

Three decades of tough-on-crime policies mean more convicts are entering prison with lengthy or life sentences. In Vermont, the number of prisoners serving life or “effectively life” (meaning the prisoner will likely die in jail) sentences doubled in the last decade, growing by anywhere between 14 and 28 individuals each year according to the annual Facts and Figures report compiled by the DOC.

A 2012 Human Rights Watch report also found that nationwide, more older individuals are entering prison for the first time — though in Vermont the percentage of first-time “entrants” to corrections involving individuals older than 50 has hovered between 7 and 10 percent for the last 12 years.

“Forgetting about whether it’s right or wrong, the economic cost of this rapidly growing aging population is going to be startling,” says Robert Greifinger, a research fellow at John Jay College of Criminal Justice. “And nobody’s really studying that.”

Greifinger formerly served as the chief medical officer for the New York prison system and has spent the last two decades consulting for the corrections industry. He says few, if any, states have pinpointed costs as they relate to caring for older inmates and their growing infirmities. “Nobody’s addressing the aging thing head-on, as they should,” he says.

Vermont corrections officials say they have not crunched the numbers, but their own data suggests the demand for specialized medical treatment is rising. While DOC doesn’t break these statistics down by age in its Facts and Figures report, Potanas estimates that two-thirds of the medical “transports” from Southern State — meaning trips to an outside facility — involve older inmates. Diagnostic tests throughout DOC are up 66 percent over the last six years; specialty appointments increased 60 percent over that same period of time; outpatient surgery, 56 percent.

At Southern State, some staff members have received special training to deal with geriatric issues. The facility is also starting an in-house hospice program, training other inmates to tend to their fellow prisoners in their final days.

Another end-of-life option: The department is trying to find Vermont nursing homes willing to take in prisoners. Ideally, Potanas says, inmates could be housed in an underused wing of a nursing home with room to spare. But when the DOC first put out a call for such facilities, says Burroughs-Biron, “We got one big goose egg for responses.”

Pallito says his department hasn’t given up. Burroughs-Biron got a list of nursing homes with beds to spare from another branch of the Agency of Human Services, and is reaching out to them directly. Pallito is trying to enlist support from the Vermont Health Care Association, the trade association that represents more than 90 licensed nursing homes and assisted-living facilities in the state.

There’s a financial incentive on both sides to get prisoners out of correctional facilities and into nursing homes. While inmates remain in prison, their medical costs are covered entirely by the state. When an inmate goes into a hospital or nursing home for an extended stay, Medicaid kicks in. For their part, nursing homes stand to gain a higher reimbursement — one-and-a-half times the normal Medicaid rate — as an incentive when they take in a prisoner-patient.

Why no takers? Some homes have expressed concern for safety of their patients and staff — when released on medical furlough, the inmates are overseen by probation officers but aren’t kept under special guard. But Burroughs-Biron points out they are typically so infirm they pose little or no risk. “This person can’t even walk,” she says, talking about a theoretical patient. “How could they commit another crime?”

If Vermont nursing homes continue to turn away DOC patients, Pallito says the department may consider more extreme measures — like building its own.

A Place for Reform

Advocates for prison reform argue against Vermont’s prison policies regarding older men and women, citing both the high cost of incarcerating these individuals and compassion for the plight of older men and women behind bars.

“In terms of taxpayer dollars, what is the appropriate use of prison?” Rep. Suzi Wizowaty (D-Burlington) asks: “To keep people away from the general public for reasons of public safety.” Holding prisoners who pose an “extremely low risk because of their age” is “a waste of taxpayer money, not to mention a waste of human capital.”

Wizowaty has introduced a bill in the Vermont House that would allow the courts to grant “compassionate release” to certain inmates, including those diagnosed with terminal illnesses; those confined to a bed or a chair; or ones older than 65 and suffering from chronic or serious medical conditions.

A separate bill from Sen. Richard Sears (D-Bennington) would grant automatic furlough to nonviolent offenders over the age of 65 who have served their minimum sentences.

Seth Lipschutz, supervising attorney in Vermont’s Prisoners’ Rights Office, characterizes these efforts as “tweaks” in a system that needs a more comprehensive overhaul. But it’s a start.

“I understand the emotions, because they’ve committed some horrendous crimes,” says Lipschutz. “They’ve caused a lot of hurt and pain in the world. If you’re going to make punishment a priority, they should all stay there, I suppose. But if you’re going to make logic and common sense a priority … then we may be misappropriating our funds.”

Pallito isn’t convinced the state needs to make any changes. He points to provisions already on the books that he says allow older inmates to be released on a case-by-case basis. The current system permits the commissioner to place an offender suffering from a terminal or debilitating condition on medical furlough “so as to render the offender unlikely to be physically capable of presenting a danger to society.” Pallito says the DOC used medical furlough three times in fiscal year 2012 and twice last year.

But Lipschutz isn’t impressed. Sure, there are provisions on the books that allow for medical release or parole, he says, but “the authorities … just seem to be kind of loath to do it.” He recalls a case years ago when he asked for medical release for a prisoner that the DOC then deemed “not sick enough.”

By the time the denial came via letter, “the guy was dead,” says Lipschutz.

Dying in prison isn’t a prospect anyone relishes — though Burroughs-Biron says that some inmates do prefer to stay put, among their fellow inmates, at the end. But it’s the new reality, according to Pallito.

“There was a period when somebody expiring in jail was considered an outlier or not acceptable,” he says. “But given the number of people that are older in jail, I think the department has put itself in a position where we [have to] do end-of-life planning for people now.”

For some prisoners, those last days and weeks play out in the infirmary at Southern State, and it’s anything but restful. Announcements click on over the loudspeaker; doors lock and unlock as staff comes and goes. “Prison is a noisy place,” says Burroughs-Biron.

Inmate Murray recalled visiting one of his friends there during the end of the man’s life. He said he took his friend outside to the prison courtyard when he felt like going out. He sat at his bedside. “I heard he died peacefully,” Murray said, but added that he doesn’t know for sure.

“We call it the death house. It’s the last place I’d want to be if I was dying,” Murray said.

The visiting room at Southern State is a dreary place, despite the colorful mural that adorns one wall. Two officers hover during the hour of conversations, circulating among them. Strict rules forbid any physical contact between inmates and their visitors.

Murray was the only older man in the room. Asked how long it had been since his last visitor, he guessed five years. His daughter has cut off ties. His friends have disappeared. It’s a problem for anyone with a long jail sentence; worse for one with more past than future.

“All those years go by,” said Murray. “People die off. They go on with their life. And I don’t blame them.”